NMC CBT FOR MIDWIVES MOCK TEST 2025

PART A

1. Question: A patient weighing 75 kg requires a drug to be administered at a dosage of 5 mcg/kg/minute. The drug is available in a solution containing 10 mg in 50 mL. What is the required infusion rate in mL/hour?
A) 112.5 mL/hour
B) 1.125 mL/hour
C) 5.625 mL/hour
D) 22.5 mL/hour

2. Question: A prescription reads: “Administer 150 mg of amoxicillin orally three times a day for 7 days.” Amoxicillin is available in a suspension containing 250 mg per 5 mL. What total volume of amoxicillin suspension, in mL, will the patient need for the entire 7-day course?
A) 63 mL
B) 105 mL
C) 126 mL
D) 42 mL

3. Question: Convert 0.045 grams to micrograms.
A) 450 micrograms
B) 45 micrograms
C) 45000 micrograms
D) 4500 micrograms

4. Question: A patient is prescribed an intravenous infusion of 1 litre of 0.9% sodium chloride solution to be administered over 8 hours. The giving set delivers 15 drops per mL. What is the required flow rate in drops per minute?
A) 21 drops/minute
B) 31 drops/minute
C) 42 drops/minute
D) 52 drops/minute

5. Question: A child weighing 20 lbs needs a medication at a dosage of 15 mg/kg/day, divided into three equal doses. The medication is available as a syrup containing 50 mg per 5 mL. What volume, in mL, should be administered per dose? (Note: 1 kg = 2.2 lbs)
A) 4.5 mL
B) 9.1 mL
C) 2.3 mL
D) 6.8 mL

6. Question: A solution has a concentration of 2.5 mmol per litre. How many micromoles are present in 250 mL of this solution?
A) 625 micromoles
B) 62.5 micromoles
C) 625000 micromoles
D) 62500 micromoles

7. Question: A patient needs to receive 750 mg of a drug. The drug is available in vials containing a powder that needs to be reconstituted with 10 mL of sterile water to give a concentration of 100 mg/mL. What volume, in mL, of the reconstituted solution is required?
A) 15 mL
B) 7.5 mL
C) 0.75 mL
D) 75 mL

8. Question: Convert a temperature of 38.5°C to Fahrenheit using the formula: °F = (°C × 9/5) + 32.
A) 99.5 °F
B) 101.3 °F
C) 69.3 °F
D) 100.4 °F

9. Question: A patient is prescribed 0.5 mg of a drug orally. The tablets available contain 250 micrograms per tablet. How many tablets are required?
A) 0.5 tablets
B) 2 tablets
C) 1 tablet
D) 4 tablets

10. Question: An infusion of 500 mL is set to run at a rate of 40 mL/hour. How long, in hours and minutes, will the infusion last?
A) 12 hours and 30 minutes
B) 1 hour and 25 minutes
C) 12 hours and 5 minutes
D) 1 hour and 15 minutes

11. Question: A patient requires 1.2 grams of a medication. The medication is available in capsules containing 300 mg each. How many capsules are needed?
A) 6 capsules
B) 4 capsules
C) 2 capsules
D) 8 capsules

12. Question: A solution has a concentration of 5% w/v. How many grams of solute are present in 300 mL of this solution?
A) 15 g
B) 6 g
C) 1.5 g
D) 60 g

13. Question: A prescription requires the administration of 10 units/hour of insulin. The insulin is prepared as 100 units in 50 mL of normal saline. What is the infusion rate in mL/hour?
A) 2 mL/hour
B) 5 mL/hour
C) 10 mL/hour
D) 20 mL/hour

14. Question: Convert 3.5 litres to cubic centimetres (cm³). (Note: 1 mL = 1 cm³)
A) 35 cm³
B) 350 cm³
C) 3500 cm³
D) 35000 cm³

15. Question: A patient is prescribed frusemide 40 mg intravenously. The ampoule contains 10 mg/mL. What volume, in mL, should be drawn up?
A) 0.25 mL
B) 4 mL
C) 2.5 mL
D) 0.4 mL

PART B

1. Question: A 32-year-old primigravida at 38 weeks gestation attends the antenatal clinic reporting reduced fetal movements over the past 24 hours. She describes the movements as “fewer and weaker” than usual. What is the most appropriate initial action?
A) Reassure the woman that reduced movements are common at term and advise her to monitor further.
B) Perform an abdominal examination to assess fetal well-being, including auscultation of the fetal heart rate.
C) Immediately refer the woman to the hospital for a cardiotocograph (CTG) assessment.
D) Advise the woman to drink a cold sugary drink and lie on her left side to try and stimulate fetal movements.

2. Question: During a home birth for a multigravida woman, the midwife observes the presence of thick meconium-stained liquor as the membranes rupture. The fetal heart rate is within the normal range (130 bpm). What is the immediate priority?
A) Prepare for immediate neonatal resuscitation, including having suction equipment readily available.
B) Continuously monitor the fetal heart rate every 15 minutes to detect any signs of fetal distress.
C) Advise the woman to push effectively with each contraction to expedite the delivery.
D) Transfer the woman to the nearest hospital with obstetric facilities due to the meconium staining.

3. Question: A postnatal woman, 4 days after a normal vaginal delivery, reports feeling increasingly anxious, tearful, and overwhelmed. She states she is struggling to sleep despite the baby sleeping well. What is the most likely explanation for these symptoms?
A) Postnatal depression requiring immediate referral to mental health services.
B) Transient postnatal “blues” which are common and usually resolve within a few days.
C) Early signs of puerperal sepsis, requiring urgent medical attention.
D) Iron deficiency anaemia exacerbated by blood loss during delivery.

4. Question: A midwife is caring for a woman in labour who has opted for epidural analgesia. The woman’s blood pressure suddenly drops to 90/60 mmHg. What is the most appropriate immediate action?
A) Increase the rate of the intravenous fluids that are infusing.
B) Administer an intramuscular injection of ephedrine as per local guidelines.
C) Place the woman in a Trendelenburg position and administer oxygen.
D) Stop the epidural infusion immediately and call the anaesthetist.

5. Question: When teaching a new mother about safe sleeping practices for her newborn, which of the following advice should the midwife prioritise?
A) Place the baby on their tummy to sleep to prevent choking on regurgitated milk.
B) Ensure the baby’s cot is in a separate room from the parents to promote independent sleep.
C) Use soft bedding such as pillows and duvets to make the cot comfortable.
D) Place the baby on their back to sleep in a cot in the same room as the parents for the first six months.

6. Question: A midwife is assessing a newborn baby and notices a single palmar crease on one hand. What should the midwife do next?
A) Document the finding as normal variation and continue with the routine newborn examination.
B) Immediately refer the baby to a paediatrician for further assessment as it could indicate Down’s syndrome.
C) Check the other hand for the presence of a similar crease and note any other dysmorphic features.
D) Inform the parents that this finding is usually associated with congenital heart defects.

7. Question: A woman at 16 weeks gestation attends her routine antenatal appointment. Her blood pressure is 145/95 mmHg. She has no other symptoms. What is the most appropriate next step?
A) Advise the woman to increase her fluid intake and monitor her blood pressure at home.
B) Repeat the blood pressure measurement after the woman has rested for 30 minutes.
C) Refer the woman to the hospital for further assessment and potential diagnosis of gestational hypertension.
D) Prescribe a low dose of antihypertensive medication as per local guidelines.

8. Question: During the third stage of labour, following the spontaneous delivery of the placenta, the midwife notes continuous heavy bleeding despite uterine contraction. What is the most likely cause?
A) Uterine inversion.
B) Retained placental fragments.
C) Uterine atony.
D) Cervical tear.

9. Question: A midwife is providing postnatal care to a woman who is breastfeeding. The woman complains of a painful, red area on her breast and feels generally unwell with flu-like symptoms. What is the most likely diagnosis?
A) Blocked milk duct.
B) Mastitis.
C) Breast abscess.
D) Thrush.

10. Question: A woman in labour expresses a desire for a water birth. What is the most important factor the midwife should consider to ensure the safety of this choice?
A) The woman’s parity and previous birth history.
B) The availability of a suitable birthing pool and adequate space.
C) The woman’s pain management preferences and coping mechanisms.
D) The absence of any maternal or fetal contraindications to water birth.

11. Question: A midwife is reviewing a woman’s antenatal records at 28 weeks gestation. The symphysis-fundal height measurement is consistently below the 10th percentile for gestational age. What is the most appropriate action?
A) Reassure the woman that fundal height measurements can vary and are not always accurate.
B) Advise the woman to increase her nutritional intake to promote fetal growth.
C) Refer the woman for an ultrasound scan to assess fetal growth and well-being.
D) Schedule more frequent antenatal appointments to closely monitor the fundal height.

12. Question: During the second stage of labour, a primigravida woman has been pushing effectively for 2 hours with no progress in descent of the fetal head. The fetal heart rate remains within the normal range. What is the most appropriate next step?
A) Encourage the woman to continue pushing with more effort.
B) Consider an instrumental vaginal delivery (forceps or ventouse).
C) Prepare the woman for an immediate Caesarean section.
D) Advise the woman to rest for an hour and then resume pushing.

13. Question: A midwife is called to assess a postnatal woman who is complaining of severe perineal pain, swelling, and difficulty sitting. On examination, there is significant bruising and a palpable haematoma. What is the most appropriate initial management?
A) Apply a cold compress to the perineal area and administer oral analgesia.
B) Encourage the woman to perform pelvic floor exercises to promote healing.
C) Immediately call the senior midwife or obstetrician for further assessment and management.
D) Advise the woman to take regular warm baths to soothe the perineal area.

14. Question: A midwife is caring for a woman who has just given birth to a baby with a known diagnosis of cleft lip and palate. What is the midwife’s priority in the immediate postnatal period?
A) Ensure the mother initiates breastfeeding within the first hour to promote bonding.
B) Provide emotional support and information to the parents regarding the diagnosis and available support services.
C) Immediately arrange for a surgical consultation for the baby’s cleft repair.
D) Monitor the baby closely for any signs of respiratory distress or feeding difficulties.

15. Question: A midwife is teaching a group of pregnant women about the benefits of breastfeeding. Which of the following is a key advantage for the baby?
A) Breast milk is less expensive than formula milk.
B) Breastfeeding helps the mother return to her pre-pregnancy weight faster.
C) Breast milk provides antibodies that protect against infections.
D) Breastfeeding guarantees the baby will have a higher IQ.

16. Question: A midwife is assessing a 5-day-old newborn and notices a yellow tinge to the baby’s skin and sclera. The baby is feeding well and otherwise appears healthy. What is the most likely cause of this jaundice?
A) Physiological jaundice.
B) Breast milk jaundice.
C) Neonatal sepsis.
D) Rhesus incompatibility.

17. Question: A woman at 34 weeks gestation presents to the maternity unit reporting a sudden onset of severe abdominal pain and vaginal bleeding. On examination, her uterus feels tense and tender. What is the most likely diagnosis?
A) Placenta praevia.
B) Ectopic pregnancy.
C) Uterine rupture.
D) Placental abruption.

18. Question: During the active phase of labour, a woman’s contractions become less frequent and less intense. What is the most appropriate initial intervention?
A) Encourage the woman to ambulate or change position.
B) Administer an intravenous bolus of fluids to improve hydration.
C) Prepare for an amniotomy to augment labour.
D) Start an oxytocin infusion to stimulate contractions.

19. Question: A midwife is providing postnatal discharge advice to a woman who had a third-degree perineal tear. Which of the following instructions is most important to include?
A) Resume normal activities and exercise as soon as she feels comfortable.
B) Use a donut cushion when sitting to relieve pressure on the perineum.
C) Avoid straining during bowel movements and consider using laxatives if needed.
D) Apply antiseptic cream to the perineal area after each void.

20. Question: A midwife is caring for a woman with gestational diabetes in labour. What is the most important aspect of fetal monitoring during this time?
A) Continuous electronic fetal monitoring (CTG).
B) Intermittent auscultation of the fetal heart rate every 30 minutes.
C) Palpation of the fetal movements every hour.
D) Regular fetal blood sampling to assess fetal wellbeing.

21. Question: A midwife is reviewing a pregnant woman’s blood results at her booking appointment. She notes the woman is Rhesus negative. What is the next appropriate step?
A) Administer anti-D immunoglobulin at 28 weeks gestation.
B) Check the father’s blood group to determine the risk of Rhesus incompatibility.
C) Advise the woman to avoid any invasive procedures during pregnancy.
D) Schedule regular blood tests throughout the pregnancy to monitor for antibodies.

22. Question: During a vaginal examination in labour, the midwife identifies the presenting part as the buttocks. What is the correct term to document this presentation?
A) Face presentation.
B) Breech presentation.
C) Brow presentation.
D) Shoulder presentation.

23. Question: A postnatal woman reports heavy lochia rubra with clots on day 10 postpartum. What is the most likely cause?
A) Normal physiological changes in lochia.
B) Retained placental fragments or subinvolution of the uterus.
C) Postpartum haemorrhage.
D) Urinary tract infection.

24. Question: A midwife is assessing a newborn who is 2 hours old. The baby’s breathing is rapid and shallow, with a respiratory rate of 65 breaths per minute. What is the most appropriate initial action?
A) Immediately call the neonatal team for urgent review.
B) Provide supplemental oxygen via nasal cannula.
C) Continue to monitor the baby closely as this is within the normal range for a newborn.
D) Gently stimulate the baby to encourage deeper breathing.

25. Question: A midwife is discussing contraception options with a postnatal woman who is breastfeeding. Which of the following methods is generally considered safe and does not interfere with lactation?
A) Combined oral contraceptive pill.
B) Depot medroxyprogesterone acetate (Depo-Provera).
C) Progestogen-only pill (POP).
D) Vaginal ring.

26. Question: A midwife is caring for a woman in labour who has a known history of group B Streptococcus (GBS) colonisation in a previous pregnancy. What is the recommended management in this labour?
A) No action is required as she was only colonised in a previous pregnancy.
B) Administer prophylactic antibiotics intravenously as soon as labour begins.
C) Perform a vaginal swab to check for current GBS colonisation.
D) Monitor the baby closely for signs of infection after birth.

27. Question: A woman at 36 weeks gestation attends the antenatal clinic complaining of severe itching, particularly on her hands and feet. She has no rash. What is the most likely diagnosis?
A) Eczema.
B) Psoriasis.
C) Obstetric cholestasis.
D) Pruritus gravidarum.

28. Question: During the second stage of labour, a midwife observes that the fetal head is visible at the vulva but does not progress with pushing efforts. This has been the case for 30 minutes. What is the correct term to describe this situation?
A) Crowning.
B) Descent.
C) Engagement.
D) Arrest of descent.

29. Question: A midwife is providing postnatal care to a woman who is bottle-feeding her baby. How should the midwife advise the woman to prepare the formula?
A) Use cooled, previously boiled water and add the powder according to the manufacturer’s instructions.
B) Use tap water that has been boiled and cooled slightly, and add extra powder for a more concentrated feed.
C) Use bottled water at room temperature and add the powder as per the baby’s appetite.
D) Prepare a large batch of formula in advance and store it in the refrigerator for up to 24 hours.

30. Question: A midwife is called to assess a newborn who is 1 day old and has not passed meconium. What is the most appropriate initial action?
A) Reassure the parents that some babies take a few days to pass their first stool.
B) Perform a thorough abdominal examination to check for any abnormalities.
C) Insert a rectal thermometer to stimulate bowel movement.
D) Immediately refer the baby to a paediatrician for further investigation.

31. Question: A midwife is discussing the importance of folic acid supplementation with a woman planning a pregnancy. What is the primary benefit of taking folic acid before conception and in early pregnancy?
A) It helps to prevent anaemia in the mother.
B) It reduces the risk of gestational diabetes.
C) It lowers the chance of the baby developing neural tube defects.
D) It improves the baby’s cognitive development.

32. Question: During labour, a woman reports feeling an urge to push before she is fully dilated. What should the midwife do?
A) Encourage her to push gently with each contraction to avoid cervical swelling.
B) Advise her to pant or blow during contractions to delay pushing until full dilatation.
C) Perform an immediate vaginal examination to assess cervical dilatation.
D) Prepare for the delivery as the second stage of labour has begun.

33. Question: A postnatal woman who is breastfeeding reports feeling a hard, tender lump in her breast. She has no fever or other systemic symptoms. What is the most likely cause?
A) Mastitis requiring antibiotic treatment.
B) A blocked milk duct that may resolve with continued breastfeeding.
C) A breast abscess requiring surgical drainage.
D) Inflammatory breast cancer.

34. Question: A midwife is assessing a newborn and notices that the baby’s skin is mottled and feels cold to the touch. The baby’s heart rate is 90 bpm. What is the most appropriate immediate action?
A) Dry the baby thoroughly and place skin-to-skin with the mother.
B) Provide positive pressure ventilation with a bag and mask.
C) Start chest compressions as the heart rate is below 100 bpm.
D) Place the baby under a radiant warmer and monitor vital signs closely.

35. Question: A midwife is providing advice to a woman who is experiencing nausea and vomiting in early pregnancy. Which of the following recommendations is most appropriate?
A) Eat large meals three times a day to maintain blood sugar levels.
B) Drink plenty of sugary drinks to prevent dehydration.
C) Try eating small, frequent meals of bland foods.
D) Avoid taking any medication, including over-the-counter remedies.

36. Question: During the third stage of labour, 30 minutes after the baby’s birth, the placenta has not yet been delivered. The woman is stable and not bleeding excessively. What is the most appropriate next step according to active management of the third stage?
A) Wait for spontaneous placental delivery for up to 60 minutes.
B) Administer an oxytocic drug intramuscularly.
C) Perform a controlled cord traction to deliver the placenta.
D) Manually remove the placenta.

37. Question: A midwife is caring for a woman who has opted for a vaginal birth after a previous Caesarean section (VBAC). Which of the following is a contraindication to VBAC?
A) Previous single low transverse Caesarean section.
B) Previous two or more Caesarean sections.
C) Maternal request for elective repeat Caesarean section.
D) Fetal macrosomia.

38. Question: A midwife is assessing a newborn and notices a soft swelling that crosses the suture lines on the baby’s head. What is the most likely diagnosis?
A) Cephalhaematoma.
B) Caput succedaneum.
C) Subgaleal haemorrhage.
D) Intracranial haemorrhage.

39. Question: A midwife is teaching a postnatal woman about perineal hygiene. Which of the following advice is most appropriate?
A) Use soap and water to wash the perineal area at least twice a day.
B) Apply antiseptic cream to the perineal area after each void.
C) Wipe from back to front after using the toilet.
D) Change sanitary pads frequently and wash hands before and after.

40. Question: A midwife is caring for a woman in labour who is HIV positive. What is the primary goal of intrapartum care to reduce the risk of vertical transmission to the baby?
A) Encourage early rupture of membranes to expedite delivery.
B) Avoid any invasive procedures such as artificial rupture of membranes or fetal blood sampling.
C) Ensure the woman receives intravenous antiretroviral medication throughout labour.
D) Recommend an elective Caesarean section at 37 weeks gestation.

41. Question: A midwife is reviewing a woman’s antenatal history and notes that she had gestational diabetes in a previous pregnancy. What is the recommended screening for gestational diabetes in this pregnancy?
A) No screening is required as she has had it before.
B) Offer a glucose tolerance test (GTT) at 16-18 weeks gestation and again at 28 weeks.
C) Offer a glucose tolerance test (GTT) at 24-28 weeks gestation.
D) Monitor blood glucose levels at each antenatal appointment.

42. Question: During the second stage of labour, a midwife observes that the fetal heart rate has dropped significantly and remains below 100 bpm for several minutes. What is the most appropriate immediate action?
A) Continue to monitor the fetal heart rate closely and document the findings.
B) Encourage the woman to change position and administer oxygen.
C) Prepare for an immediate instrumental vaginal delivery.
D) Call for senior obstetric help and prepare for emergency delivery.

43. Question: A postnatal woman on day 3 postpartum reports feeling very thirsty and passing large amounts of urine frequently. She denies any pain or burning on urination. What is the most likely explanation?
A) Urinary tract infection.
B) Gestational diabetes that has persisted postpartum.
C) Normal physiological diuresis in the postnatal period.
D) Dehydration due to inadequate fluid intake.

44. Question: A midwife is assessing a newborn and notices a small, white, pearly cyst on the baby’s nose. What is the correct term for this finding?
A) Milia.
B) Mongolian spot.
C) Erythema toxicum.
D) Strawberry naevus.

45. Question: A midwife is discussing infant feeding options with a new mother who has decided to formula feed. What is the recommended frequency of feeding for a newborn in the first few weeks?
A) On a strict 4-hourly schedule.
B) Only when the baby cries for food.
C) Responsively, whenever the baby shows signs of hunger.
D) Every 6 hours, including overnight.

46. Question: A midwife is caring for a woman in labour who is experiencing strong, frequent contractions but reports feeling increasingly anxious and overwhelmed. What is the most appropriate intervention?
A) Encourage her to focus on her breathing and relaxation techniques.
B) Offer her pharmacological pain relief options such as an epidural.
C) Advise her that labour is progressing normally and to try to relax.
D) Leave her alone to rest between contractions.

47. Question: A woman at 41 weeks gestation attends the antenatal clinic for a routine appointment. She reports feeling well and fetal movements are normal. What is the recommended management?
A) Offer induction of labour as she is beyond her due date.
B) Schedule a further antenatal appointment in one week.
C) Advise her to monitor fetal movements closely and return if concerned.
D) Perform a membrane sweep to try and initiate labour.

48. Question: During the third stage of labour, following the delivery of the placenta, the midwife notes a small amount of bleeding from a cervical tear. What is the most appropriate initial action?
A) Apply pressure to the area to try and stop the bleeding.
B) Suture the tear immediately to prevent further blood loss.
C) Observe the bleeding closely and document the amount.
D) Call for senior midwifery or obstetric advice.

49. Question: A midwife is providing postnatal care to a woman who is experiencing significant breast engorgement on day 3 postpartum. Which of the following advice is most appropriate to offer?
A) Apply warm compresses to the breasts before feeding and cold compresses afterwards.
B) Avoid expressing any milk to prevent further stimulation.
C) Restrict fluid intake to reduce swelling.
D) Wear a tight-fitting bra to provide support.

50. Question: A midwife is assessing a newborn and notices a bluish discoloration of the baby’s hands and feet. The central colour is pink, and the baby is otherwise well. What is the correct term for this finding?
A) Central cyanosis.
B) Acrocyanosis.
C) Jaundice.
D) Pallor.

51. Question: A midwife is discussing the importance of vitamin K administration to newborns with expectant parents. What is the primary reason for giving vitamin K to a newborn?
A) To prevent anaemia.
B) To boost the baby’s immune system.
C) To prevent haemorrhagic disease of the newborn.
D) To promote bone development.

52. Question: During labour, a woman in the first stage expresses a desire to use a transcutaneous electrical nerve stimulation (TENS) machine for pain relief. What advice should the midwife provide?
A) TENS is most effective in the second stage of labour.
B) TENS can be used at any stage of labour and the woman should be encouraged to use it if she finds it helpful.
C) TENS is contraindicated in women with epilepsy.
D) TENS should only be used under the guidance of a physiotherapist.

53. Question: A postnatal woman who had a Caesarean section is being discharged home on day 5. Which of the following instructions regarding wound care is most important for the midwife to provide?
A) Apply an antiseptic cream to the wound daily.
B) Keep the wound dry and clean, and report any signs of infection.
C) Avoid showering or bathing until the wound has completely healed.
D) Remove the wound dressing after 24 hours.

54. Question: A midwife is assessing a newborn and notices a swelling on the baby’s scalp that is limited by the suture lines and feels firm. What is the most likely diagnosis?
A) Caput succedaneum.
B) Cephalhaematoma.
C) Subgaleal haemorrhage.
D) Subconjunctival haemorrhage.

55. Question: A midwife is providing advice to a woman who is planning a home birth. Which of the following is an essential piece of equipment that should be readily available?
A) A fetal Doppler or Pinard stethoscope.
B) Intravenous fluids and administration set.
C) A resuscitation trolley with full neonatal resuscitation equipment.
D) Entonox (gas and air) cylinder.

56. Question: A midwife is caring for a woman in labour who has pre-eclampsia. Which of the following is a critical sign or symptom that requires immediate attention?
A) Mild headache.
B) Ankle swelling.
C) Epigastric pain.
D) Increased frequency of urination.

57. Question: A woman at 30 weeks gestation presents with painless vaginal bleeding. What is the most likely diagnosis?
A) Placental abruption.
B) Vasa praevia.
C) Cervical ectropion.
D) Placenta praevia.

58. Question: During the active phase of labour, a midwife performs a vaginal examination and finds the cervix to be 7 cm dilated with the fetal head at station -1. Four hours later, a repeat examination shows the cervix is still 7 cm dilated and the station remains -1. What is the correct term to describe this situation?
A) Secondary arrest of labour.
B) Protracted active phase.
C) Failure to progress.
D) Latent phase of labour.

59. Question: A midwife is providing postnatal advice to a woman who is concerned about her baby’s frequent bowel movements. The 2-week-old breastfed baby is passing loose, yellow stools after almost every feed and is gaining weight well. What is the most appropriate advice?
A) Advise the mother to switch to formula feeding.
B) Reassure the mother that this is normal for a breastfed baby.
C) Recommend that the mother seeks medical advice for possible diarrhoea.
D) Suggest the mother eliminates dairy from her diet.

60. Question: A midwife is assessing a newborn and notes a single umbilical artery and vein. What should the midwife do next?
A) Document the finding as a normal variation.
B) Immediately refer the baby for a renal ultrasound scan.
C) Inform the parents that this is usually associated with chromosomal abnormalities.
D) Perform a thorough examination to look for other congenital anomalies.

61. Question: A midwife is discussing the benefits of skin-to-skin contact for newborns immediately after birth. Which of the following is a key benefit?
A) It reduces the risk of jaundice.
B) It promotes early initiation of breastfeeding and helps regulate the baby’s temperature.
C) It guarantees the baby will have a stronger immune system.
D) It prevents the baby from crying.

62. Question: During labour, a woman experiences a sudden episode of heavy vaginal bleeding accompanied by severe abdominal pain and fetal distress. What is the most likely cause?
A) Ruptured vasa praevia.
B) Uterine rupture.
C) Placenta praevia.
D) Cervical tear.

63. Question: A postnatal woman reports feeling sad, anxious, and having difficulty bonding with her baby on day 10 postpartum. These feelings are persistent and interfering with her daily life. What is the most appropriate action?
A) Reassure her that these feelings are normal and will pass soon.
B) Advise her to get more rest and support from her family.
C) Refer her to her GP or mental health services for further assessment and support for possible postnatal depression.
D) Suggest she tries some relaxation techniques and mindfulness exercises.

64. Question: A midwife is assessing a newborn and notices a small, reddish birthmark on the baby’s nape of the neck. It blanches with pressure. What is the most likely diagnosis?
A) Strawberry naevus.
B) Port-wine stain.
C) Salmon patch (stork mark).
D) Mongolian spot.

65. Question: A midwife is providing advice to a woman who is experiencing heartburn during pregnancy. Which of the following recommendations is most appropriate?
A) Lie down immediately after eating.
B) Eat large, infrequent meals.
C) Avoid spicy and fatty foods.
D) Drink plenty of acidic fruit juices.

66. Question: During the third stage of labour, after administering an oxytocic drug, the midwife performs controlled cord traction to deliver the placenta. Suddenly, there is a gush of blood and the uterus inverts. What is the immediate priority?
A) Apply fundal pressure to try and reposition the uterus.
B) Call for immediate obstetric emergency help and stop the cord traction.
C) Clamp and cut the umbilical cord immediately.
D) Administer another dose of oxytocic drug to help the uterus contract.

67. Question: A midwife is caring for a woman who has a known history of epilepsy and is in labour. What is the most important consideration during her care?
A) Ensuring she has adequate pain relief to prevent seizures.
B) Avoiding continuous electronic fetal monitoring as it can trigger seizures.
C) Having anti-epileptic medication readily available and monitoring for seizure activity.
D) Encouraging early ambulation to help progress labour.

68. Question: A midwife is assessing a newborn and notices that the baby has not passed urine in the first 24 hours of life. What is the most appropriate initial action?
A) Document the finding and reassure the parents.
B) Increase the frequency of feeding to promote urination.
C) Gently palpate the baby’s abdomen to check for bladder distension.
D) Immediately refer the baby to a paediatrician for further assessment.

69. Question: A midwife is providing advice to a postnatal woman about pelvic floor exercises. When is the most appropriate time to start these exercises after a vaginal delivery?
A) Immediately after delivery.
B) Once the perineal pain has completely subsided.
C) Around 6 weeks postpartum.
D) Only if the woman experiences urinary incontinence.

70. Question: A midwife is caring for a woman in labour who has requested Entonox (gas and air) for pain relief. What is an important instruction to give the woman about its use?
A) Inhale deeply and continuously throughout the contraction.
B) Start inhaling the gas and air just as the contraction begins.
C) Only use the Entonox between contractions to avoid feeling lightheaded.
D) It is most effective if used in the second stage of labour.

71. Question: A midwife is reviewing a pregnant woman’s blood results and notes a low haemoglobin level (10.5 g/dL) at 28 weeks gestation. What is the most appropriate initial recommendation?
A) Advise the woman to increase her intake of iron-rich foods.
B) Prescribe a high dose of iron supplements immediately.
C) Refer the woman to a haematologist for further investigation.
D) Reassure the woman that this is a normal finding in pregnancy.

72. Question: During the second stage of labour, a midwife observes that the fetal head is distending the vulva but the perineum appears thin and at risk of tearing. What action should the midwife take to try and prevent a severe perineal tear?
A) Encourage the woman to push with maximal effort to expedite delivery.
B) Apply firm pressure to the perineum to support it during pushing.
C) Advise the woman to push gently and control the delivery of the head.
D) Prepare for an episiotomy.

73. Question: A postnatal woman on day 7 postpartum reports feeling a sudden onset of severe pain in her calf, which is red, swollen, and tender to touch. What is the most likely diagnosis?
A) Superficial thrombophlebitis.
B) Deep vein thrombosis (DVT).
C) Cellulitis.
D) Muscle strain.

74. Question: A midwife is assessing a newborn and notices a clicking sound when abducting and externally rotating the baby’s hips. What should the midwife do next?
A) Document the finding as normal as it is common in newborns.
B) Immediately refer the baby to an orthopaedic specialist for assessment of possible hip dysplasia.
C) Advise the parents to keep the baby’s legs swaddled tightly together.
D) Perform further examination to assess for other signs of hip dysplasia, such as asymmetry of skin folds.

75. Question: A midwife is discussing the importance of immunisations for newborns with new parents. Which of the following statements is accurate regarding the UK’s routine immunisation schedule?
A) The first immunisations are usually given at birth.
B) The first immunisations are usually given at 2 months of age.
C) Immunisations are only recommended for babies at high risk of infection.
D) All childhood immunisations contain live vaccines.

76. Question: A midwife is caring for a woman in labour who has a history of female genital mutilation (FGM). What is an important consideration during her care?
A) Avoiding vaginal examinations to minimise discomfort.
B) Being sensitive to the woman’s cultural background and potential physical and psychological effects of FGM.
C) Automatically recommending a Caesarean section to avoid complications.
D) Assuming the woman will have difficulty with labour and delivery.

77. Question: A woman at 39 weeks gestation calls the maternity unit reporting a sudden gush of clear fluid from her vagina. She is not having any contractions. What is the most appropriate advice?
A) Stay at home and wait for contractions to start.
B) Come into the hospital immediately for assessment.
C) Monitor her temperature regularly and come in if she develops a fever.
D) Try to induce labour naturally by going for a walk.

78. Question: During the second stage of labour, a midwife observes that the fetal head has been at the same station for more than an hour in a primigravida woman with adequate contractions. What is the most likely cause?
A) Maternal exhaustion.
B) Fetal malposition or malpresentation.
C) Inadequate pushing efforts.
D) Premature rupture of membranes.

79. Question: A postnatal woman who is breastfeeding expresses concern that her baby is not getting enough milk. Which of the following is a reliable sign that a breastfed baby is feeding adequately in the first few days of life?
A) The baby feeds for at least 30 minutes at each breast.
B) The baby is sleeping for long stretches between feeds.
C) The baby has at least six wet nappies in 24 hours after day 5.
D) The baby demands to be fed every hour.

80. Question: A midwife is assessing a newborn and notices a small, bluish-grey flat mark on the baby’s buttock. What is the correct term for this finding?
A) Strawberry naevus.
B) Port-wine stain.
C) Salmon patch.
D) Mongolian spot.

81. Question: A midwife is discussing the importance of maintaining a healthy weight during pregnancy. Which of the following risks is increased for women with obesity in pregnancy?
A) Hyperemesis gravidarum.
B) Preterm labour.
C) Placenta praevia.
D) Gestational diabetes.

82. Question: During labour, a woman experiences a sudden episode of severe back pain between contractions. Vaginal examination reveals the cervix is fully dilated. What fetal position is most likely?
A) Occipito-anterior.
B) Occipito-posterior.
C) Breech.
D) Transverse lie.

83. Question: A postnatal woman on day 1 postpartum has a temperature of 38.5°C. She reports feeling generally unwell and has mild abdominal tenderness. What is the most likely cause?
A) Breast engorgement.
B) Urinary tract infection.
C) Puerperal sepsis.
D) Postnatal blues.

84. Question: A midwife is assessing a newborn and notices that the baby’s breathing stops for periods of 5-10 seconds, followed by a period of rapid breathing. The baby’s colour remains pink, and heart rate is stable. What is the correct term for this breathing pattern?
A) Apnoea.
B) Tachypnoea.
C) Periodic breathing.
D) Bradypnoea.

85. Question: A midwife is providing advice to a woman who is planning to travel by airplane during her second trimester of pregnancy. Which of the following recommendations is most important?
A) Avoid flying altogether during pregnancy.
B) Wear compression stockings and move around frequently during the flight.
C) Ensure she has travel insurance that covers pregnancy-related complications.
D) Drink plenty of caffeinated beverages to stay alert.

86. Question: A midwife is caring for a woman in labour who has a known allergy to penicillin. What is the most important action to take if the woman requires prophylactic antibiotics for group B Streptococcus?
A) Administer a small test dose of penicillin to check for reaction.
B) Ensure that an alternative antibiotic is prescribed and administered.
C) Avoid giving any antibiotics to minimise the risk of allergic reaction.
D) Inform the woman that she cannot have prophylactic antibiotics due to her allergy.

87. Question: A woman at 20 weeks gestation attends her routine scan. The ultrasound reveals oligohydramnios. What does this finding indicate?
A) An excessive amount of amniotic fluid.
B) A reduced amount of amniotic fluid.
C) The presence of multiple gestations.
D) A fetal anomaly.

88. Question: During the second stage of labour, a midwife observes that the fetal head rotates to the occipito-posterior position. What is the likely effect on the progress of labour?
A) Labour will progress more quickly.
B) The woman may experience increased back pain and the second stage may be prolonged.
C) The risk of perineal tearing will be reduced.
D) Instrumental delivery will always be required.

89. Question: A postnatal woman who is breastfeeding reports experiencing nipple pain and cracking. What is the most likely cause?
A) Thrush infection.
B) Incorrect latch.
C) Mastitis.
D) Blocked milk duct.

90. Question: A midwife is assessing a newborn and notices that the baby’s blood glucose level is 2.0 mmol/L. The baby is jittery and feeding poorly. What is the most appropriate immediate action?
A) Recheck the blood glucose level in one hour.
B) Encourage frequent breastfeeding.
C) Administer intravenous glucose as per local guidelines.
D) Place the baby skin-to-skin with the mother.

91. Question: A midwife is discussing the importance of attending antenatal appointments with a woman in her first trimester. Which of the following is a key benefit of regular antenatal care?
A) It guarantees a problem-free pregnancy and delivery.
B) It allows for early detection and management of potential complications.
C) It is only necessary for women with high-risk pregnancies.
D) It primarily focuses on providing emotional support to the woman.

92. Question: During labour, a woman who has requested an epidural for pain relief experiences a dense block that extends to her legs, making it difficult to push effectively. What intervention might be considered?
A) Reducing the rate of the epidural infusion.
B) Administering an oxytocin infusion to increase the urge to push.
C) Encouraging the woman to push with all her strength despite the lack of sensation.
D) Preparing for an instrumental delivery as pushing may be ineffective.

93. Question: A postnatal woman on day 14 postpartum reports a sudden onset of heavy vaginal bleeding that is bright red. She feels dizzy and lightheaded. What is the most likely cause?
A) Normal lochia serosa transitioning to lochia alba.
B) Secondary postpartum haemorrhage due to retained placental fragments or infection.
C) A urinary tract infection causing blood in the urine.
D) Ovulation returning.

94. Question: A midwife is assessing a newborn and notices that the baby has passed a thick, greenish-black stool. What is the correct term for this first stool?
A) Transitional stool.
B) Meconium.
C) Milk stool.
D) Diarrhoeal stool.

95. Question: A midwife is providing advice to a woman who is planning to return to work 8 weeks after giving birth and intends to continue breastfeeding. What is an important piece of advice to offer regarding maintaining milk supply?
A) She will need to switch to formula feeding as breastfeeding is difficult to maintain when working.
B) She should express milk regularly at work to maintain her milk supply and provide milk for her baby.
C) She should only breastfeed when she is at home with the baby.
D) Her milk supply will naturally adjust to the baby’s needs even if she doesn’t express at work.

96. Question: A midwife is caring for a woman in labour who is experiencing a shoulder dystocia. After the initial manoeuvres have been unsuccessful, what is the next recommended action according to the HELPERR mnemonic?
A) Call for help.
B) Evaluate for episiotomy.
C) Legs – McRoberts manoeuvre.
D) Pressure – suprapubic pressure.

97. Question: A woman at 12 weeks gestation attends her booking appointment and reports a history of recurrent urinary tract infections. What prophylactic treatment might be considered?
A) Increased fluid intake only.
B) Regular cranberry juice consumption.
C) Low-dose antibiotics throughout the pregnancy.
D) Post-coital antibiotics.

98. Question: During the second stage of labour, a midwife observes prolonged decelerations in the fetal heart rate that do not recover to baseline. What is the most likely cause?
A) Fetal head compression.
B) Uteroplacental insufficiency.
C) Maternal position.
D) Administration of epidural analgesia.

99. Question: A postnatal woman on day 2 postpartum reports feeling very emotional and tearful, even when she doesn’t know why. She states she feels overwhelmed and anxious. What is the most appropriate response from the midwife?
A) Reassure her that these “baby blues” are common and usually resolve within a few days.
B) Advise her to seek immediate medical help as these are signs of postnatal depression.
C) Suggest she is just tired and needs more sleep.
D) Encourage her to take some time for herself and relax.

100. Question: A midwife is assessing a newborn and notices that the baby has a weak suck reflex. What is the most important initial step in managing this finding?
A) Advise the parents to bottle-feed the baby.
B) Refer the baby to a speech and language therapist immediately.
C) Assess the baby’s overall condition, feeding attempts, and consider potential underlying causes.
D) Encourage the parents to stimulate the baby’s suck reflex frequently.